Abstract:
BACKGROUND:Ileal pouch-anal anastomosis (IPAA) for ulcerative colitis(UC) can be performed as either 2- or 3-stage procedure. IPAA in the elderly has been reported as safe and feasible, but little work to date has assessed outcomes by procedure. The aim of our study was to assess use and short-term outcomes of 2- and 3-stage IPAA in older adults. METHODS:The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was searched for ≥ 65-year-old patients who underwent IPAA for UC in 2- or 3-stage from 2012 to 2016. The primary endpoint was the rate and trends of the two approaches over time. Secondary endpoints included 30-day adverse events and complication-associated costs. RESULTS:Overall, 123 patients were included: 77.5% (n = 83) 2-stage and 40 (32.5%) 3-stage IPAA. Mean age was 68.7 ± 3.9 years, with 43 (34.9%) women. The use of the 3-stage IPAA increased over time (18.8% in 2012 vs. 33.3% in 2016), with decreasing use of 2-stage IPAA(81.3% vs. 66.7%, p < 0.001). The morbidity associated with the procedures decreased over time, overall (81.3% in 2012 and 51.5% in 2016, p < 0.001) and in each group individually. No differences were observed in postoperative complications across groups (45.8% 2-stage, 32.5% 3-stage). The overall mean costs of care when no postoperative complications occurred was $25,910, vs. $38,577 when any complication occurred (p < 0.001), but no differences were observed between groups. CONCLUSIONS:In a national analysis, there was a trend of increasing 3-stage vs. 2-stage IPAA for UC in older Americans. Complications and complication-associated costs were comparable across approaches, suggesting that the choice of procedure type should be based on the specific patient comorbidities and surgeon preferences.
journal_name
Tech Coloproctoljournal_title
Techniques in coloproctologyauthors
Pellino G,Reif de Paula T,Lawlor G,Keller DSdoi
10.1007/s10151-020-02327-1subject
Has Abstractpub_date
2020-08-16 00:00:00eissn
1123-6337issn
1128-045Xpii
10.1007/s10151-020-02327-1pub_type
杂志文章abstract:INTRODUCTION:Colorectal transport in idiopathic fecal incontinence has scarcely been studied, and it remains to be investigated in patients with fecal incontinence and anal sphincter lesion. The aim of the present study was to compare colorectal transport during defecation in patients with idiopathic fecal incontinence...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0652-6
更新日期:2011-03-01 00:00:00
abstract::The currently used technology for transanal excision of rectal neoplasms is diathermy. However, control of bleeding is sometimes difficult. The Harmonic Scalpel provides a "dry" surgical field which facilitates the procedure and allows complete resection of the neoplasm with greater accuracy. ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-008-0427-5
更新日期:2008-09-01 00:00:00
abstract::Hereditary proctalgia is an extremely rare condition characterized by endosonographic evidence of internal anal sphincter (IAS) thickening and specific ultrastructural changes seen at light and electron microscopy (EM). We report the case of a 54-year-old Caribbean woman with severe proctalgia and IAS thickening, trea...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-007-0329-y
更新日期:2007-03-01 00:00:00
abstract::Stapled hemorrhoidopexy is a widely used surgical technique for treating hemorrhoids, although severe complications have been reported. The authors report a rare case of extensive ascending intramural hematoma of the sigmoid colon complicating stapled hemorrhoidopexy, with perforation and hemoperitoneum. Diagnosis was...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0696-2
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Studies have shown differences in postoperative outcomes between two minimally invasive extraction methods for colorectal lesions-natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLS). The aim of this study was to discover the major differences in NOSES and CLS to re...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-020-02330-6
更新日期:2020-08-26 00:00:00
abstract::Colouterine fistula is a rare clinical entity. A literature search revealed only a few reports dealing with this complex problem, mostly resulting as a complication of diverticular disease of the colon. During a 4-month period, we diagnosed and successfully treated 2 women with a malignant colouterine fistula originat...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-009-0555-6
更新日期:2010-03-01 00:00:00
abstract::Hepatic resection for colorectal liver metastases remains the only therapeutic option that improves long-term survival and offers potential cure. By conventional resectability criteria, only a limited number of patients with metastatic disease can be subjected to surgical intervention. In the past decade, better under...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0750-0
更新日期:2011-10-01 00:00:00
abstract::Peripheral neuropathy associated with anesthesia is a significant source of morbidity and the second most frequent cause of professional liability in anesthetic practice. Nerve injuries are a well-recognised complication of anesthesia. Brachial plexus neuropathy is a rare syndrome with an incidence of 1.6 cases per 10...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-005-0212-7
更新日期:2005-07-01 00:00:00
abstract::Intussusception of the appendix is a rare condition. We present the case of a 72-year-old woman with multiple polyps in the colon with an appendix completely intussuscepted into a polyp within the caecum. The clinical features, preoperative diagnosis, classification and treatment of this condition are discussed with r...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0068-2
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Early detection of colorectal anastomotic leakage (AL) may lead to better outcome. AL may be preceded by change in local metabolism and local ischaemia. Microdialysis of the peritoneal cavity is able to measure these changes in real-time and is minimally invasive. The aim of this prospective cohort study was...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1020-0
更新日期:2014-01-01 00:00:00
abstract:PURPOSE:Introduction of stapled hemorrhoidopexy (SH) brought a radical change in the treatment of haemorrhoidal disease. The aim of this study is to evaluate the results and the complications (early and late) from the use of this technique. METHODS:During the last 6 years (2005-2011), 123 patients underwent a SH in ou...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0739-8
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the role of confocal laser endomicroscopy (CLE) in the assessment of disease activity in ulcerative colitis (UC). METHODS:Consecutive patients with UC referred to our inflammatory bowel disease unit for colonoscopy were enrolled. Patients without UC were used as cont...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-017-1654-4
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Ileal pouch-anal anastomosis (IPAA) following proctocolectomy is the preferred option for patients with medically refractory ulcerative colitis, indeterminate colitis, and familial adenomatous polyposis. However, it remains a procedure associated with morbidity and mortality. Pelvic sepsis, pouch fistulae, a...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0757-6
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Achieving full recovery after colorectal cancer surgery means a return to normal physical and psychological health and to a normal social life. Recovery data focusses on time to discharge rather than longer term functionality including return to work (RTW). We aim to assess return to normal holistic function...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-014-1232-y
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The use of biological materials for the repair of complex abdominal wall defects has increased over the years; however, the role of these materials in routine practice remains unclear. The aim of the study was to evaluate clinical outcomes following the use of Permacol™ porcine collagen surgical implant in c...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-015-1307-4
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Obese patients have higher complication rates after pelvic surgery. Laparoscopic rectal surgery may not be possible in the obese individual due to mesorectal, total pelvic and general visceral fat volumes. Very low energy diets reduce visceral fat but the changes within the pelvis and mesorectum are unknown....
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-019-02074-y
更新日期:2019-09-01 00:00:00
abstract::Despite improvements in medical therapy, the annual high mortality rate from end-stage heart failure continues. Although cardiac transplantation is a successful treatment for these patients, the shortage of donor hearts has led surgeons to seek other options. Ventricular assist device (VAD) technology is applied to a ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-007-0365-7
更新日期:2007-09-01 00:00:00
abstract::Stapled hemorrhoidopexy is an alternative method to conventional surgical procedures for third-degree hemorrhoids. It has many advantages such as less pain, faster recovery and earlier return to work. Nevertheless, many reports mentioned the persistence of postoperative pain, hemorrhage, recurrence, sphincter injury, ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-005-0236-z
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Although the Hinchey scoring system has guided surgical decision making for perforated diverticulitis, what constitutes optimal surgical management is controversial. We report our experience of selective primary closure of the perforation without use of a transverse colostomy and the specific circumstances i...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0675-7
更新日期:2011-06-01 00:00:00
abstract::The treatment techniques for pilonidal disease are either associated with high recurrence rates or complex procedures. This prospective randomized study compared the outcome of excision and marsupialization technique with sinus excision technique. A total of 40 consecutive patients with limited, chronic pilonidal sinu...
journal_title:Techniques in coloproctology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s101510200037
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Large bowel obstruction is occasionally the mode of presentation of advanced colorectal or pelvic malignancies, and a prognostic of poor survival. The choices of treatment range from palliative tube decompression to curative or palliative surgery. METHODS:Twelve out of 500 women with various malignancies an...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0127-8
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Perineal wound complications are frequently observed after abdominoperineal resection (APR) for rectal cancer, especially in preoperatively irradiated patients. This is the first study to investigate whether local application of gentamicin-impregnated collagen fleece reduces deep perineal wound infection aft...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-008-0440-8
更新日期:2008-12-01 00:00:00
abstract:AIM:The aim of this study is to review the time between formation and closure of loop ileostomies following total mesorectal excision in patients with rectal cancer. PATIENTS AND METHODS:A retrospective study of 170 patients who underwent low anterior resection for rectal cancer, between 1990 and 2009. Loop ileostomie...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0628-6
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Ligation of the intersphincteric tract (LIFT), a novel sphincter-saving technique, has been recently described with promising results. Literature data are still scant. In this prospective observational study, we present our experience with this technique. METHODS:Between October 2010 and April 2011, 18 pati...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0779-0
更新日期:2011-12-01 00:00:00
abstract::There is still no clear consensus about surgical treatment of anal fistulas. Fistulotomy or fistulectomy and primary sphincter reconstruction is still regarded with skepticism. The aim of this systematic review was to evaluate the evidence in the literature supporting the use of this technique in the treatment of comp...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-015-1323-4
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Technical feasibility of inferior rectal nerve anastomosis to the anterior vagus branch of the perineally transposed antropyloric valve for total anorectal reconstruction has been previously demonstrated in cadavers. To the best of our knowledge, the present study is the first report of using this procedure ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1092-x
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:This is the first systematic review specifically investigating ileocolic anastomosis. OBJECTIVES:To compare outcomes of ileocolic anastomoses performed using stapling and handsewn techniques. The hypothesis tested was that the stapling technique is associated with fewer complications. SEARCH STRATEGY:MEDLI...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-019-02105-8
更新日期:2019-11-01 00:00:00
abstract::Anal fistula repair still remains challenging. Up to 30% of fistulas persist after surgery despite many improvements in surgical skills and technique. One major reason for surgical failure is a persistent fistula track or remnants of the fistula epithelium which could not be removed during surgery. To overcome this pr...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0726-0
更新日期:2011-12-01 00:00:00
abstract::A 44-year-old man presented with a large and rapidly growing skin lesion approximately six months after resection of a rectal carcinoma. The lesion measured 40 cm in size, extended from the suprapubic area to the proximal half of the left groin, and showed a particular zosteriform aspect. Biopsy confirmed a metastatic...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-003-0019-3
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:The aim of this study is to underscore the incidence of synchronous polyps in patients with colorectal cancer and to emphasise the importance of their perioperative detection and management. PATIENTS AND METHODS:Three hundred and seven patients underwent a potentially curative resection for colorectal cance...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0117-x
更新日期:2004-11-01 00:00:00